Melanoma crude incidence rates among white South Africans climbing as in other countries : an urgent call for targeted skin cancer prevention and awareness campaigns

Abstract

Melanoma, an aggressive cancer that is potentially fatal if not treated early, remains a public health challenge in several countries around the world. Exposure to solar ultraviolet radiation (UVR) is a modifiable risk factor for melanoma among lightly pigmented people. However, behavioural changes are required to reduce excessive sun exposure, and infrastructure and policy support are needed, particularly in high solar UVR environments. Large, multicomponent skin cancer awareness campaigns and interventions, such as those implemented in Australia, have shown some success. Such activities are typically less expensive than melanoma treatment, which is costly to the individual and the country, especially a middle-income country such as South Africa (SA). Using previously unpublished historical data and data from the SA National Cancer Registry (NCR), the crude incidence per 100 000 population for melanoma was compared with three other countries at different latitudes with significant melonoma burdens. In this study, we sought to describe trends in melanoma incidence in white South Africans, among whom melanoma is more common than in other population groups, to inform skin cancer prevention efforts. Melanoma also occurs in black South Africans, albeit at a lower prevalence. However, in this population group, factors such as presence of scar tissue and lack of early self-screening rather than excessive sun exposure play a role in its causation. We therefore focused our analyses on white South Africans, for whom avoiding excess sun exposure is critical to melanoma prevention.